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Evaluation of changes in kinetic parameters of the gait in patients after correction of the flatfoot by using of a subtalar implant - preliminary report
Author(s):
Lukasik Edyta (Poland)
,
Lukasik Edyta (Poland)
Affiliations:
Mioduszewski A.
,
Mioduszewski A.
Affiliations:
Swierczynski R.
,
Swierczynski R.
Affiliations:
Wrobel M.
,
Wrobel M.
Affiliations:
Wychowanski M.
,
Wychowanski M.
Affiliations:
Jopek Renata
Jopek Renata
Affiliations:
ESSKA Academy. Lukasik E. May 9, 2018; 209220; P01-1888
Edyta Lukasik
Edyta Lukasik
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Abstract
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Objectives: Flatfoot is one of the most common foot defects in children and adults. It is a consequence of the hypermobility of subtalar joint. Due to the fact that an excessive internal rotation of the talus is transferred on the above body segments (causing functional valgus of the lower limb) and leads to an overload of the lower limb musculoskeletal system. Interesting direction seems to be the minimally invasive surgical technique of flatfoot correction through the external bone stabilization of the tarsal sinus by using subtalar implant (EOTTS - Extra-Osseous TaloTarsal Stabilization).

The aim of the study was to evaluate the size of the musculoskeletal load in patients who were one year after the correction of flatfoot by using of a subtalar implant.

Methods: The study group consisted of 12 people of both sexes - 3 women, 9 men (age: 21.4 ± 8.9 years, body weight: 63.9 ± 15.2 kg, body height: 164.5 ± 13.3 cm), who had made bilateral correction of flatfeet by using the subtalar implant. The exclusion criterion of the experiment were traumatic or surgical procedures in the lower limb in the past, rheumatological and neurological diseases. Patients were examined just before surgery and 1 year after surgery.
The musculoskeletal load was assessed on the basis of kinetic analysis of the lower limb during gait. Their measurements were made using the motion analysis system VICON and conjugated with its the dynamometric platform Kistler company. In the study were used 34 markers, which were placed on the body of the subject in accordance with the Full Body Plug-In-Gait Lower Limb (SACR) protocol. Each patient had to walk 4 to 6 times on designated path with preferred speed. The analysis used 3 trials that were considered valid. We analized the maximum values of force moments of ankle, knee, hip in the sagittal, frontal and transverse planes, occurring in the Stance Phase of gait (in time from 0% to 60% phase of the gait cycle). The measurements were made in the Central Research Laboratory of the Physical Education Academy in Warsaw.

Results: In the kinetic analysis of gait was estimated at 24 feet. There was no significant changes in kinetic parameters within the ankle. In the frontal plane of knee in the second half of the stance phase was significant decrease of the maximum value of knee abductor moment (before surgery: 0.47 ± 0.16 Nm/kg, one year after the procedure: 0.32 ± 0.08 Nm/kg ) (p <0.05). In the frontal plane of hip in the first half of stance phase, before the surgery there was hip adductor moment (-0.16 ± 0.71 Nm / kg), while one year after the surgery there was hip abductor moment (0.64 ± 0.32 Nm / kg). Using the student- t test checked whether the comparing values were differ significantly.

Conclusions: Preliminary results indicate that one year after correction of the flatfoot by using the subtalar implant a significantly decrease of knee load in the frontal plane during the tearing heel off the ground.

Keywords:
flatfeet, heel valgus, sinus tarsi implant, gait pattern, gait analysis
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